Assessing endgame strategies for the elimination of lymphatic filariasis: A model-based evaluation of the impact of DEC-medicated salt

Abstract Concern is growing regarding the prospects of achieving the global elimination of lymphatic filariasis (LF) by 2020. Apart from operational difficulties, evidence is emerging which points to unique challenges that could confound achieving LF elimination as extinction targets draw near. Diet...

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Autores principales:	Morgan E. Smith, Brajendra K. Singh, Edwin Michael
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5b24df0c89a94dc1a5415938f474c523
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spelling	oai:doaj.org-article:5b24df0c89a94dc1a5415938f474c5232021-12-02T15:05:53ZAssessing endgame strategies for the elimination of lymphatic filariasis: A model-based evaluation of the impact of DEC-medicated salt10.1038/s41598-017-07782-92045-2322https://doaj.org/article/5b24df0c89a94dc1a5415938f474c5232017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-07782-9https://doaj.org/toc/2045-2322Abstract Concern is growing regarding the prospects of achieving the global elimination of lymphatic filariasis (LF) by 2020. Apart from operational difficulties, evidence is emerging which points to unique challenges that could confound achieving LF elimination as extinction targets draw near. Diethylcarbamazine (DEC)-medicated salt may overcome these complex challenges posed by the endgame phase of parasite elimination. We calibrated LF transmission models using Bayesian data-model assimilation techniques to baseline and follow-up infection data from 11 communities that underwent DEC salt medication. The fitted models were used to assess the utility of DEC salt treatment for achieving LF elimination, in comparison with other current and proposed drug regimens, during the endgame phase. DEC-medicated salt consistently reduced microfilaria (mf) prevalence from 1% mf to site-specific elimination thresholds more quickly than the other investigated treatments. The application of DEC salt generally required less than one year to achieve site-specific LF elimination, while annual and biannual MDA options required significantly longer durations to achieve the same task. The use of DEC-medicated salt also lowered between-site variance in extinction timelines, especially when combined with vector control. These results indicate that the implementation of DEC-medicated salt, where feasible, can overcome endgame challenges facing LF elimination programs.Morgan E. SmithBrajendra K. SinghEdwin MichaelNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-12 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Morgan E. Smith Brajendra K. Singh Edwin Michael Assessing endgame strategies for the elimination of lymphatic filariasis: A model-based evaluation of the impact of DEC-medicated salt
description	Abstract Concern is growing regarding the prospects of achieving the global elimination of lymphatic filariasis (LF) by 2020. Apart from operational difficulties, evidence is emerging which points to unique challenges that could confound achieving LF elimination as extinction targets draw near. Diethylcarbamazine (DEC)-medicated salt may overcome these complex challenges posed by the endgame phase of parasite elimination. We calibrated LF transmission models using Bayesian data-model assimilation techniques to baseline and follow-up infection data from 11 communities that underwent DEC salt medication. The fitted models were used to assess the utility of DEC salt treatment for achieving LF elimination, in comparison with other current and proposed drug regimens, during the endgame phase. DEC-medicated salt consistently reduced microfilaria (mf) prevalence from 1% mf to site-specific elimination thresholds more quickly than the other investigated treatments. The application of DEC salt generally required less than one year to achieve site-specific LF elimination, while annual and biannual MDA options required significantly longer durations to achieve the same task. The use of DEC-medicated salt also lowered between-site variance in extinction timelines, especially when combined with vector control. These results indicate that the implementation of DEC-medicated salt, where feasible, can overcome endgame challenges facing LF elimination programs.
format	article
author	Morgan E. Smith Brajendra K. Singh Edwin Michael
author_facet	Morgan E. Smith Brajendra K. Singh Edwin Michael
author_sort	Morgan E. Smith
title	Assessing endgame strategies for the elimination of lymphatic filariasis: A model-based evaluation of the impact of DEC-medicated salt
title_short	Assessing endgame strategies for the elimination of lymphatic filariasis: A model-based evaluation of the impact of DEC-medicated salt
title_full	Assessing endgame strategies for the elimination of lymphatic filariasis: A model-based evaluation of the impact of DEC-medicated salt
title_fullStr	Assessing endgame strategies for the elimination of lymphatic filariasis: A model-based evaluation of the impact of DEC-medicated salt
title_full_unstemmed	Assessing endgame strategies for the elimination of lymphatic filariasis: A model-based evaluation of the impact of DEC-medicated salt
title_sort	assessing endgame strategies for the elimination of lymphatic filariasis: a model-based evaluation of the impact of dec-medicated salt
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/5b24df0c89a94dc1a5415938f474c523
work_keys_str_mv	AT morganesmith assessingendgamestrategiesfortheeliminationoflymphaticfilariasisamodelbasedevaluationoftheimpactofdecmedicatedsalt AT brajendraksingh assessingendgamestrategiesfortheeliminationoflymphaticfilariasisamodelbasedevaluationoftheimpactofdecmedicatedsalt AT edwinmichael assessingendgamestrategiesfortheeliminationoflymphaticfilariasisamodelbasedevaluationoftheimpactofdecmedicatedsalt
_version_	1718388645700829184

Assessing endgame strategies for the elimination of lymphatic filariasis: A model-based evaluation of the impact of DEC-medicated salt

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